A vote against Issue 64 would reject the Cleveland Clinic’s escape from its lease on Lakewood Hospital. The Clinic owed Lakewood 278 million dollars under that lease, according to Cleveland Clinic documents uncovered in a taxpayers’ lawsuit against the Clinic and city officials.

In contrast, city officials terminated that lease in favor of a deal that gave the Clinic more than 100 million dollars of hospital assets for a mere 9.6 million dollars. The deal replaced Lakewood’s full service hospital with a “satellite” emergency department that is in reality little more than an urgent care center, unable to handle real emergencies like heart attacks, strokes, severe burns and head injuries. To make things worse, satellite emergency rooms like the one planned for Lakewood mean skyrocketing costs to consumers.

City officials are asking voters to approve the new agreement by voting for Issue 64.

But suspicions among Lakewood voters are reaching critical mass since this bombshell development just a few weeks ahead of the November election. Many feel that special interests have taken priority at city hall. Feedback from door to door canvasing and phone banking has demonstrated that voters are set to express their displeasure with city officials by voting against Issue 64, and overturning the deal that closed Lakewood Hospital.

The Cleveland Clinic has mailed a postcard to Lakewood residents, digging in on misleading claims about its freestanding emergency department. No one should be fooled; the claim that Clinic physicians “skillfully treat… cardiac arrest and stroke” is still carefully separated from any promise that they do so in Lakewood. The don’t, and no one should turn to Lakewood’s ER for anything other than delays in real treatment for these conditions.

Meanwhile, this glossy advertisement makes another promise, less directly dangerous but even more plainly false: “In Lakewood. For Lakewood.” Really?

Having done all this, the Cleveland Clinic then claimed that Lakewood Hospital was financially unsustainable, and lobbied city officials to hand over its assets in return for a a much smaller health center which the Clinic will own.

The Save Lakewood Hospital Committee today released a letter which former Congressman Dennis J. Kucinich personally delivered to the Federal Trade Commission (FTC) on Friday, May 13, 2016 which asks the FTC to determine if the Cleveland Clinic failed to make a required filing under the Hart-Scott-Rodino Act (H-S-R), in its machinations involving its planned termination of in-patient care at Lakewood Hospital.

Kucinich, who served Lakewood and the greater Cleveland area in the US House for 16 years submitted the filing as part of a continuing battle at the FTC which began with an extensive brief filed last October.

In the latest complaint, (see attachments) Kucinich raises three points:

There is no evidence that a mandatory filing was made regarding the Clinic’s Lakewood transaction. Across America, larger hospital systems have been taking over smaller health care systems, flying under the regulatory radar of the FTC through various maneuvers of questionable legality. Kucinich pointed out that the asset value of Lakewood Hospital is at least $120 million; a consultant valued the hospital at $70 million, and an associated investment pool at $50 million. “Even viewing the transaction as the wind-down of a collaboration, such as a joint-venture, it still should have been reviewed under the H-S-R Act, because of the value of the assets involved in the deal,” Kucinich wrote.

Kucinich raises the question as to whether the Clinic sought to avoid a filing under Hart-Scott-Rodino, in order to avoid FTC scrutiny of the Clinic’s market concentration in the greater Cleveland area, through a review known at the Herfindahl-Hirschman Index. “If H-S-R filings, though required, are simply not made, regulators lack sufficient information to prompt a Herfindahl-Hirschman Index (‘HHI’) review to determine market concentration.”

Kucinich raised questions of improper bidding procedures. “There is reason to believe, based upon documentary evidence, that the transaction which led to the closing of Lakewood Hospital was steered to Cleveland Clinic by virtue of that party’s active participation in the development of the offering process; and that during the offering process Clinic employees, or trustees had access to review offers of its competitors.” Kucinich submitted documentary evidence of the efforts of a second bidder.

Marguerite Harkness, Chair of the Save Lakewood Hospital Committee, said, “Congressman Kucinich has raised serious questions which deserve the attention of the Federal Trade Commission. He is speaking for many people in the community who feel that the entire Lakewood Hospital deal stinks.”

Tom Monahan, Vice-Chair of Save Lakewood Hospital Committee said, “It is inspiring that Kucinich repeatedly comes to our defense when our own local public officials keep selling us out. He’s still involved and that’s very good for our community.”

Advocates for Lakewood Hospital have drawn attention to a statement at the Clinic’s own web site*, posted barely a year ago, advising that “Some situations are clearly an emergency: A heart attack, fall off a ladder, serious kitchen burn or bone break. You know to call 9-1-1 and to get your loved one to the nearest hospital,” i.e. an actual hospital and not a freestanding emergency department.

Apparently, both Lakewood City Council and the Clinic are reluctant to directly confront the limitations of care without a hospital. In a full-page ad on page 3 of the April 13 Observer, the Clinic touts “full-service emergency care” in Lakewood, “always close to home.”

Unfortunately, this and the rest of the Clinic’s advertising about services in Lakewood is mostly an exercise in misrepresentation. Given that there is no fixed definition of “emergency department,” the claim of “full-service” emergency care is largely meaningless.

“They move the rehab unit out and you might as well kiss that place goodbye,” Polensek said Wednesday. “We can’t let them do to Euclid what they did to Lakewood and East Cleveland. What’s happening here is outrageous, and they wonder why the average citizen is so angry with the corporate elite.”

…Polensek said the move is taken from a Cleveland Clinic playbook to remove services from facilities that it wants to close or reduce in size. He wrote a letter to Pamela Holmes, a senior government relations executive with the Clinic, protesting the move.

“The Clinic moves out services and health care related programs and then indicates sometime later to the community that the institution is losing money and/or patients or is in poor condition,” Polensek wrote in the letter, adding: “Then it is only a matter of time before the hospital closes and they serve us up some reduced health care facility with some deceased former officials name on it, which is nowhere near the services once being offered by a full service hospital.”

Addressing Lakewood City Council Monday evening, attorney Gerald Phillips lent his support to repealing ordinance 49-15, which closed Lakewood Hospital, and “starting all over.” Mr. Phillips roundly criticized the ordinance, which will go before Lakewood voters in November.

Mr. Phillips’ statement is republished below, with permission:

The following are examples of malfeasance, misfeasance and non-feasance of the City Council and the Mayor of Lakewood:

I. The complete failure to provide for the waiver of facility fees for Lakewood residents who are unable to pay for them;

II. The complete failure to provide for a guarantee amount of charity care for Lakewood residents; in the past as much as $7 million was provided through Lakewood Hospital; none is guaranteed by the Master Agreement;

III. The complete failure to enforce the breach of the lease agreement by the Lakewood Hospital Association and the breach of the Definitive Agreement by the Cleveland Clinic; no consideration at all was received in light of their material breaches as part of their fraudulent plan to close Lakewood Hospital;

Wednesday, February 24th was a very busy day for the Save Lakewood Hospital Committee and Citizens for a Strong Lakewood members, who protested at two high profile speaking events.

At 6 AM, committee members protested in front of the Intercontinental Hotel next to the Clinic as invitees filed past on their way to Clinic CEO Toby Cosgrove’s “State of The Clinic” address. Temperatures were in the low 40’s as a soaking rain fell, but that didn’t dampen committee member spirits. Commuters honked their horns and gave members thumbs-up as rush hour traffic swelled on Carnegie Avenue. Local TV covered the protest and reported on morning broadcasts. Crain’s Cleveland Business’s health reporter, who was one of the invitees, tweeted a photo of the protest and a link from our YouTube Channel (https://youtu.be/Yzf4EDK25Xs).

Twelve hours later, the committee re-enacted the scene at Lakewood Mayor Mike Summers’s State of the City address at the Lakewood Masonic Temple. Just as was the case earlier that day, the falling rain soaked committee members as they picketed on Detroit Avenue in front of the Temple. This time the honking horns and cheers of approval were even more intense than they had been before. The sound of horns and cheers filled the main hall of the Temple as council members shuffled in for the address.

Once the address commenced, committee members joined the small group of Mayor Summers’s supporters in the Temple’s main hall. Empty as the hall was, it provided a chance to dry off after what had been a very successful day. The committee’s visibility has made it clear to everyone that the campaign for health care justice in our community is far from over. The committee continues its commitment to save lives, save jobs, save Lakewood and to save Lakewood Hospital. The issue that will determine the future of our hospital will be on the ballot some time in 2016.Read More

Wednesday, February 24th will be a busy day for the Save Lakewood Hospital Committee as members will be protesting at two high-profile speaking events.

At 6 AM committee members will carry on a protest in front of the Intercontinental Hotel at 9801 Carnegie Avenue where the “State of The Clinic” address will be given by Cleveland Clinic CEO Toby Cosgrove.

Twelve hours later at 6 PM, committee members will assemble for the “State of the City” address, delivered by Lakewood Mayor Mike Summers. The evening address will be delivered at the Lakewood Masonic Temple, 15300 Detroit Avenue, Lakewood.

The Save Lakewood Hospital Committee wish it could be said that The Cleveland Clinic is a good steward of public health in Northeast Ohio, but court documents have proven otherwise. The Clinic deliberately mismanaged Lakewood Hospital to make it appear to be unprofitable. Their egregious and morally corrupt actions contributed directly to the closing of our publicly owned hospital, putting lives at risk, and have deprived us of our largest employer. We are rallying to demand restitution. It is time The Clinic put lives before their Wall Street style corporate greed.

In December of 2015, city officials taking the advice of Clinic personnel and surrogates, passed legislation that gave Lakewood’s publicly owned community hospital to the Cleveland Clinic, literally at pennies on the dollar. There was no open bidding process. City officials ignored three offers from qualified health care operators.

Our hospital’s future remains in limbo until the time when city officials, required by law, place the hospital issue on the ballot in 2016.

On Monday evening, Lakewood city council rubber-stamped a secretly negotiated 11th-hour plan to surrender Lakewood Hospital to Cleveland Clinic. The Clinic intends, with this authority, to complete its illicit decanting of what has always been a community-owned hospital, and to lock up health care in Lakewood for Clinic-owned hospitals elsewhere. Facing multiple lawsuits and possible investigations of their maladministration, the Clinic and its apologists apparently hope to thwart justice with a fait accompli.

The people of Lakewood do not have to let this happen. Council has embraced a false narrative of the Clinic or nothing, blatantly ignoring the active overtures of a fully qualified alternative. Lakewood owes it to future generations, as well as the most vulnerable populations now and tomorrow, to employ every legal means to block the handover of our hospital and negotiate an alternative to the Cleveland Clinic’s dishonesty and theft.

Please don’t begin the coming year by giving up on your community. If council has lost the will to fight for Lakewood’s interests, honest working citizens have not.

1) Lakewood Hospital is Owned by the Citizens Of Lakewood. The land and buildings, every MRI, ultrasound, operating table, every piece of lab equipment—right down to each light bulb—are all owned by Lakewood residents.

2) The Clinic Leases the Hospital. There are 10 more years left on the lease.

3) A $400 Million Lawsuit Has UnearthedSecret Documents and testimonies revealing that the Clinic planned and implemented the destruction of Lakewood Hospital with empty promises to make the hospital sustainable for years to come. Dennis Kucinich explains in this video.

4) The Hospital Was Profitable until this year, even after the Clinic removed nearly two dozen services and departments beginning in 2007, culminating this past January with the closing of the cardiac catheterization lab. The Clinic said the state health department made them close this most profitable unit, which was not true. The City’s three representatives on the Lakewood Hospital Association (LHA) board did nothing. City Council stood by tacitly as the hospital was steadily emptied of valuable resources.

The City of Lakewood web site now includes a FAQ about the proposed new “Master Agreement” with Cleveland Clinic. Naturally—given the disastrous proposal it defends—it is another muddle of evasions and internal contradictions.

Q: “What makes you trust the Clinic?” A: “…Trust doesn’t enter in this. It’s about the numbers and the assurances in the legally binding agreement…”

Q: “Why can’t you detail all the services that will be available at the new health center?” A: “The city doesn’t want to be in the business of micromanaging any health care providers’ services…”

So, it isn’t about trust, it’s about the “assurances in the legally binding agreement”. But there aren’t any assurances because we don’t “want to be in the business of micromanaging”.

The assertion that Lakewood will be guaranteed anything by a “legally binding agreement” with Cleveland Clinic is daft. Cleveland Clinic cheats. By contrast, Mayor Summers’s administration has already refused to support a lawsuit against the Clinic’s sabotage of the current agreement, and Summers himself said this fall that “I don’t believe in suing and auditing your way to success.”

Council members, by contrast, tied themselves into rhetorical knots trying to defend the indefensible.

The most revealing example may be Councilman Tom Bullock’s assertion that “Some times your choices are between two bad… I think that’s what we’re in here.” This summarized a theme repeated throughout the evening, that council is trying to deal with “reality” and that an imperfect deal with Cleveland Clinic is better than an alternative of a bankrupt hospital. As one public speaker after another pointed out, however, the two bad choices proposed by Mr. Bullock are a false reality created by Council; city officials have not only failed to make a sincere pursuit of alternatives, but have recently refused even to engage with one alternative that has actively sought them out.

Councilman David Anderson claimed that “we cannot compel LHA to reopen the process” to contact alternative hospital systems, and Councilman Shawn Juris insisted that city officials “don’t have a direct obligation, or a way to compel a health care provider to provide services.” Yet this is blatantly contradicted by council’s own repeated statements.

In May, Council vice president Ryan Nowlin wrote—in a letter actively soliciting information from Metrohealth—that “City council is perfectly free to consider any proposals regarding the future of healthcare in Lakewood, and indeed we are obligated to do so as community stewards if such a proposal is presented.” During Monday’s meeting, Councilman Bullock stated that “If the Tennessee group [Surgical Development Partners] makes a concrete proposal” he would be interested in talking to them; meanwhile the repeated references by every member of council to “negotiations” with Cleveland Clinic confirm that council not only has more leverage than Mr. Anderson proposed, but has also applied a double-standard in exempting Cleveland Clinic from the demands it would apply to Surgical Development Partners.

The agreement would cancel the 11 years remaining on Cleveland Clinic’s lease of the hospital and absolve the Clinic of all its associated responsibilities, costing Lakewood millions.

The emergency department would be substantially smaller than Lakewood Hospital’s, and require several thousand people per year to find emergency care elsewhere. Emergency services will undoubtedly do their best to help people reach that care—but constantly transporting people to hospitals outside Lakewood will inevitably stretch response times. (No wonder the real, front-line crews are concerned.)

The agreement supposedly will arrange for a Cleveland Clinic mobile stroke unit “to be allowed to be used in Lakewood.” This is an existing Clinic unit—one, only—which already exists and is based at Lutheran Hospital where it will remain. Lakewood gains essentially nothing here.

All of the contents of Lakewood Hospital—which still belongs to the people of Lakewood and always has—are to be handed over to Cleveland Clinic without compensation or even an appraisal.

The relatively small payment to Lakewood, by Cleveland Clinic, is to be made in installments over more than a decade. The Clinic’s annual revenues are nearly $10 billion, next to which the total of these payments is microscopic, which raises questions about why the Clinic wants to delay them and whether it is any more likely to fulfill the terms of a new agreement than those of the current one.

The city promises to restrict the “prime land” cited as an exciting benefit of closing the hospital, in ways that will effectively block any other health care firm from providing services there.

The Family Health Center with which Cleveland Clinic proposes to replace Lakewood Hospital is scheduled to open in the middle of 2018, but the agreement explicitly includes provision for that date to slide into mid-2019. This says much about the priority that Cleveland Clinic will attach to health care in Lakewood.

Lakewood City Council has scheduled a special meeting for December 14—at a special, early time—for a second reading of its proposed agreement to close Lakewood Hospital.

At 5:00 p.m., Save Lakewood Hospital will explain the misguided details of the proposed Agreement with the Cleveland Clinic Foundation.

Please join us on Monday at City Hall. (Unlike city officials’ closed-door press conference, all will be welcome at our presentation.) Stick around afterward and at 6 p.m. confront council with the real people whom they are trying to ignore.

Other important dates in the next week:

Sunday, Dec. 13 at 4:00 p.m., Save Lakewood Hospital has a meeting in the Multi-Purpose Room at the Main Branch of Lakewood Library. Please try to attend.

Thursday, Dec. 17th. Angelo’s Pizza at 13715 Madison is an all-time favorite haunt of Lakewoodites, and SLH is having a fundraiser there from 11 a.m. – 10 p.m.

Angelo’s will donate 20% of all food and non-alcoholic drinks – provided you mention the Save Lakewood Hospital fundraiser. Good on: Dine-in, Carry-out, Delivery, Gift Cards…. just be sure to mention the Save Lakewood Hospital fundraiser.

After weeks of rumors, on Monday evening Lakewood city officials unveiled another plan to close Lakewood Hospital, at an unannounced press conference just hours before a city council meeting. Council plans to make a second reading of the plan on December 14, at an additional meeting that was also a last-minute announcement (and, as of Tuesday morning, is still unlisted on the city’s online calendar). The regular meeting on December 21 is currently proposed for a third reading and vote.

Despite having withheld notice of this proposal as long as possible, council was joined by a substantial number of citizens Monday evening. At least a dozen people spoke to council about the proposal, all but one of whom were critical of Cleveland Clinic, the plan, and the questionable haste in a two-week lead-up to a vote four days before Christmas with two lame-duck council members.

Meanwhile, with a lawsuit in progress, and two requests for independentinvestigations which may become even more compelling as a result of these proceedings, the viability of officials’ intention to “move forward” will remain in doubt.

Everyone concerned about Lakewood Hospital—and about the basic values of honest, inclusive, responsible government—is encouraged to contact members of council.

Beginning in 2001, financial statements for Lakewood Hospital Association introduced a line for “Administrative services” costs. Starting at $2.4 million in 2001, these costs balloon to more than twenty-four million dollars in 2013. Save Lakewood Hospital has questioned high fees paid by LHA to the Cleveland Clinic for operating Lakewood Hospital, before, but the exact progression of this line item through 14 years should be sobering reading for everyone interested in Lakewood’s future:

Yet the nature of these expenses remains unexplained and unquestioned by the same LHA trustees and city administrators consistently asserting that Lakewood Hospital is financially unviable.

Lakewood Hospital and Lakewood deserve better stewardship than this.

Note: audited financial statements for 2009, 2010, 2011, 2012, 2013 and 2014 are available from the City of Lakewood’s web site. Earlier statements have been released, by city Law Director Kevin Butler, in connection with a taxpayers’ lawsuit; please see this PDF with 2001 and 2002 Administrative services costs as comparison.

Alongside the questions asked of Dennis Kucinich by journalists, at his press conference on Monday, a handful of attendees demanded “what about St. Michael’s?” Fifteen years ago, St. Michael’s Hospital in Slavic Village also faced closure, before a community effort aided by then-Congressman Kucinich intervened. The “Miracle on Broadway” resulted in a sale to University Hospitals, which spent several million dollars renovating St. Michael’s.

It is often remarked that “those who fail to learn from history are doomed to repeat it,” and St. Michael’s does offer some lessons with relevance for Lakewood. These do not, however, include “give up, don’t fight for the hospital, it will only delay the inevitable.”

On June 21, 2012, three years before the plan to close and raze Lakewood Hospital was revealed to the public and beneficiaries of the charitable trust, Cleveland Clinic Foundation (CCF) representatives met to discuss the decanting plan of Lakewood Hospital. (Ex. 2).

Under the decanting plan,

30-45 beds from Lakewood Hospital’s nursing unit will be moved to Fairview Hospital;

16 intensive care unit beds at Lakewood Hospital will be moved to Fairview Hospital;

Fairview Hospital will absorb 700-800 births per year from Lakewood Hospital;

7,000-8,000 Lakewood Hospital inpatient emergency department visits will be moved to Fairview Hospital;

1,315-1,773 inpatient surgeries per year will be moved from Lakewood Hospital to Fairview Hospital;

Lakewood Hospital physicians will be moved to Fairview Hospital and other CCF wholly-owned hospitals;

12 geropsych beds will be moved from Lakewood Hospital to Lutheran Hospital;

Lakewood Hospital’s vascular laboratory will be moved to Fairview Hospital;

some Lakewood Hospital inpatient beds will be moved to Fairview Hospital;

and inpatient surgery and the catheterization laboratory at Lakewood Hospital will be moved to Fairview Hospital. (Ex. 1).

All of these services, employees, and equipment that have been moved and will continue to be moved away from Lakewood Hospital are City assets. More importantly, those assets belong to a charitable trust for the charitable purpose of providing high quality health care to the third party beneficiaries of the trust: City taxpayers and residents, Lakewood Hospital employees, and the general public.

Proponents of razing Lakewood Hospital and approving the Cleveland Clinic letter of intent would have us believe that there is no other option on the table. “Where’s their alternative,” they ask—though only rhetorically, because if they were actually to ask Save Lakewood Hospital they would receive an answer:

The Cleveland Clinic signed a lease to run Lakewood Hospital, and provide specific services, through 2026. It’s now 2015; much can happen in a decade. Therefore, even setting aside serious doubts about the sincerity with which the mayor and hospital association actually tried to secure a new partner, there is no reason to assume that “there’s no alternative to the Clinic” is a final, unalterable fact.

The Cleveland Clinic has claimed an ongoing “commitment to Lakewood,” despite its campaign to escape its lease agreement and demolish the city’s hospital. Commitment, however, seemed to be the most elusive quantity when Clinic representatives addressed city council Thursday night.

Councilwoman Cindy Marx asked if Cleveland Clinic officials would guarantee Lakewood Hospital employees jobs elsewhere if the local hospital closed. [Clinic chief of regional hospitals Brian] Donley said the clinic looks to provide every employee in good standing who wants a job with a job somewhere in the Cleveland Clinic system or with a partner. However, after the meeting, he said that while the Clinic would make every effort to place every employee, he would not use the word “guarantee.”

Meanwhile, Clinic representatives boasted of how their proposed family health center would offer residents more services than Lakewood Hospital (from which the Clinic has been eliminating services). Despite which, “Clinic officials could not [specify] which specialties would be available at the Lakewood facility. That is yet to be determined.”